Injury was first recognised as a national health priority for Australia in 1986 and injury prevention was one of five National Health Priority Areas (NHPA) endorsed by Australian Health Ministers in 1997 (Department of Health and Ageing (DoHA) 2003). While there has been some debate about the definition of injury, generally it involves a set of circumstances (a cause) and an adverse outcome, such as physical or mental harm (Langely and Brenner 2003). In Australia, injury is the principal cause of death in people under 45 years of age, and a leading cause of mortality, morbidity and permanent disability. Throughout the 1990s, injury was annually responsible for more than 7,000 deaths, 400,000 hospitalisations and direct medical costs of $2.6 million (National Health and Medical Research Council (NHMRC) 1999). While injuries cause a range of physical, cognitive and psychological disabilities and are a major source of health care costs, there are significant opportunities for reducing the burden of injury through the implementation of prevention strategies (Australian Institute of Health and Welfare (AIHW) & Department of Health and Family Services (DHFS) 1998).

This publication presents statistics and analysis of recent injuries reported from a four week period in 2001, as collected as part of the National Health Survey. Information on these recent injuries include where they took place, who was injured, what activity was being performed, what type of event led to the injury, the location and nature of the injury damage resulting, and what action was taken following the injury.

Statistics on current long-term conditions caused by injury are also presented, including the nature of the long-term condition and whether the injury was sustained at work, while playing sport, or in a motor vehicle accident. Selected risk factors, such as socioeconomic disadvantage, alcohol consumption, work-related injuries, and participation in sport and leisure are also analysed. This publication focuses on analysis of recent non-fatal injuries as reported by respondents. Information on deaths from injuries will be separately published in Deaths From External Causes, Australia (1997 to 2002) (Cat. No. 3320.0).

PREVALENCE OF INJURIES

RECENT INJURIES

In 2001, 12% of persons (13% of males and 11% of females) reported sustaining a recent injury in the four weeks before the interview (see Explanatory Notes for a description of the injuries module).

PROPORTION WHO WERE RECENTLY INJURED - 2001

When the type of event leading to injury is considered, there were similar numbers of males and females being injured by falls. However, there were differences between the sexes for other types of event leading to injury. For example, 63% of people who reported being injured by a collision were male.

PERSONS REPORTING RECENT INJURY EVENTS - 2001

Males

Females

Persons

Type of injury event

'000

'000

'000

Falls(a)

406.4

397.9

804.3

Collisions(b)

293.3

174.5

467.8

Bite or sting

98.5

128.7

227.3

Attack by another person

37.3

17.8

55.2

Exposure to fire

23.0

32.2

55.1

Vehicle accident

33.7

16.9

50.6

Exposure to chemical

*15.1

*6.6

21.7

Other event resulting in action

452.0

357.1

809.0

Total with injury event(c)

1,222.4

1,027.7

2,250.1

Without injury

8,142.5

8,523.7

16,666.2

Total

9,364.9

9,551.4

18,916.3

* estimate has a relative standard error of between 25% and 50% and should be used with caution(a) Includes low falls of one metre or less and high falls of over one metre.(b) Hitting something or being hit by something.(c) Persons may have reported more than one type of event and therefore components may not add to totals.

Of all injuries, the type of damage reported included open wounds (44% of injured people), bruising (33%), burns and scalds (8%), fractures (4%), poisoning (2%), and concussion (1%). More than one-quarter of the injured (27%) were involved in leisure activities at the time of their injury, and just under half occurred in and around the home (49%). Sports facilities or sports fields were the next most common location for injury (16%), with people who exercised at high or moderate levels reporting sporting injuries at higher rates than those who were sedentary or exercised at low levels.

LONG-TERM CONDITIONS RESULTING FROM INJURY

Results from the 2001 NHS indicated that 2,256,300 people in Australia have a long-term condition that was the result of an injury. This represents 15% of those with a long-term condition and 12% of the total Australian population.

Around 24% of musculoskeletal and connective tissue disorders were caused by an injury. In particular, 44% of neck pain and problems, 40% of disc problems and 45% of arthropathies other than arthritis (such as pain or problems with the shoulder, limbs, hands or feet) were caused by an injury.

CAUSES AND OUTCOMES OF RECENT INJURIES

Causes of recent injury analysed include falls, collisions, bites or stings, attacks by people, and motor vehicle accidents. In addition injuries resulting in long-term conditions which were caused by a motor vehicle accident, and statistics on the outcomes of recent injury, such as burns and scalds, can also be analysed from 2001 NHS results.

FALLS

Over 804,300 Australians of all ages (4% of all Australians) fell and injured themselves in the four weeks before interview (table 5). Most of these falls (92%) were less than one metre in height. Overall, 9% of people who fell attended hospital. However, of the 8% of people who fell more than one metre, 20% attended hospital.

RECENTLY INJURED BY A FALL, Age group - 2001

Low falls(a)

High falls(b)

Total falls

Proportion of persons who fell

Age group (years)

'000

'000

'000

%

0-4

130.9

*6.0

135.3

10.6

5-9

160.8

*12.9

172.8

12.9

10-14

101.6

*11.0

112.6

8.5

15-19

62.2

*7.2

69.3

5.3

20-24

51.5

*7.2

58.7

4.7

25-34

56.3

*5.0

61.3

2.2

35-44

58.5

*4.7

63.3

2.2

45-54

37.5

*3.9

41.4

1.6

55-64

36.0

*3.8

39.0

2.2

65+

48.6

**2.0

50.6

2.2

Total

743.9

63.7

804.3

4.3

* estimate has a relative standard error of between 25% and 50% and should be used with caution** estimate has a relative standard error greater than 50% and is considered too unreliable for general use(a) Falls of one metre or less.(b) Falls of over one metre.

RECENTLY INJURED BY A FALL, Selected activities(a) - 2001

COLLISIONS (HITTING SOMETHING OR BEING HIT BY SOMETHING)

Collisions were the second most common type of recent injury. Males were injured by collisions at higher rates than females; 31 per 1,000 males compared to 18 per 1,000 females.

The types of activity being undertaken at the time of the collision differed between males and females. For example, 31% of males injured by collision were playing organised sport at the time compared to 20% of females. In contrast, an estimated 29% of females injured by collision incurred their injury engaged in domestic activity, compared to 13% of males.

BITE OR STING

Bites or stings were the third most common recent injury (1% of all respondents) and include bites from animals such as dogs and snakes, and from some insects and spiders (see Glossary for further detail).

Most people who were bitten or stung were outside their own or someone else's home. An estimated 15% of people who were bitten or stung reported being poisoned as a result, or reported the bite or sting resulted in an open wound (14%).

ATTACK BY ANOTHER PERSON

Results from the 2001 NHS show that an estimated 55,200 people (3 per 1,000) experienced recent injury as a result of an attack by another person. The age group with the highest rate of recent injury as a result of an attack were children aged 5-14 years (8 per 1,000), and of those, most were male (77%).

RECENTLY INJURED BY AN ATTACK BY ANOTHER PERSON - 2001

VEHICLE ACCIDENT

Recent injury

Approximately 3 in 1,000 people experienced a recent injury as a result of a vehicle accident (see Glossary). People aged 15-24 years experienced a higher rate of recent injury from vehicle accidents when compared to people aged 35 years and over.

VEHICLE ACCIDENT INJURIES, Selected items - 2001

Persons

%

Location

Street or highway

63.0

Farm

*10.3

Outside own or someone else's home

*8.8

Activity

Leisure activities

35.8

Working for an income

*26.0

Type of damage

Bruising

57.1

Open wound

34.4

Dislocations, sprains, strains, torn muscles/ligaments

30.8

Body part injured

Legs/feet

47.0

Back/spine

*28.4

Arms/wrists

*24.1

Neck(c)

*22.4

Action taken

Cut down on usual activities

55.9

Visited doctor/other health professional

51.7

Attended hospital

32.0

Had time off work/study

43.3

Total with recent vehicle accident injury(d)

100.0

Proportion of the population recently injured in a vehicle accident

0.3

* estimate has a relative standard error of between 25% and 50% and should be used with caution(a) Includes recent injuries from both motorised and non-motorised vehicle accidents. See Glossary.(b) As the NHS surveys households only, injured people who were in hospital at the time of the survey were not enumerated and therefore, statistics shown may be underestimated.(c) Excludes spine.(d) Persons may have reported more than one of the items above and therefore, components may not add to totals.

Long-term conditions

In 2001, an estimated 495,300 people reported having a long-term condition which was caused by a motor vehicle accident (see Glossary). Motor vehicle traffic accidents caused 22% of long-term conditions resulting from injury. Back pain and other problems were common long-term conditions and joint injuries and disc disorders where also relatively frequent. Additionally, 5% of those with a motor vehicle traffic accident related long-term condition suffered from mental and behavioural problems. These problems involved brain damage and symptoms such as feeling depressed, nervous or anxious.

LONG-TERM CONDITIONS FROM INJURY, Motor vehicle accident(a) - 2001

BURNS AND SCALDS

The 2001 National Health Survey classified burns and scalds as injury damage (i.e. an outcome of an injury event), rather than as a cause of recent injury in itself (refer Explanatory Notes for more detail). Results from the survey indicate that 170,800 people received a recent burn or scald. This represented 8% of people reporting a recent injury and 1% of all Australians.

People aged 15-24 years reported the highest rate of burns and scalds in 2001. Of these, 73% were burnt or scalded while working for an income. This may reflect the type of work people from this age group undertake and the risks involved in that type of work.

RECENTLY INJURED BY BURN OR SCALD, Age group - 2001

SPECIAL CIRCUMSTANCES AROUND RECENT INJURY

ALCOHOL CONSUMPTION

Adults at high risk of long-term health problems due to alcohol consumption were more than twice as likely as adults who do not consume alcohol to report one or more recent injuries in the four weeks before interview.

RECENTLY INJURED PERSONS(a), Alcohol risk level(b) - 2001

SOCIAL CONDITIONS

INDEX OF RELATIVE SOCIOECONOMIC DISADVANTAGE

The rate of recent injury among those living in areas with highest and lowest levels of disadvantage are similar across age groups. Similarities were also found between actions taken, such as attending a hospital, visiting a doctor or other health professional, cutting down on usual activity and taking days off work or study. No significant differences in rates of the various injury events were found between people in the highest and lowest areas of socioeconomic disadvantage.

EMPLOYMENT STATUS

For the younger age groups between 15 and 34 years old, higher rates of injury were found among those employed (16%) compared to those not in the labour force (11%).

ACTIVITY AND INJURY

SPORT RELATED INJURIES AND EXERCISE

Recent injuries incurred during sport

Results from the 2001 NHS indicate that an estimated 367,200 people reported a recent injury as a result of participating in organised sport, two-thirds of whom were male.

Exercise level

People who participate in organised sport, and exercise at high to moderate levels, had a higher rate of recent injury when compared by age to those who participate in sport and exercise at sedentary or low levels. For example, 9.3% of 15-24 year olds who exercised at high or moderate levels reported a recent injury while participating in sport, compared to 1.6% of 15-24 year olds who exercised at low levels or were sedentary.

Long-term conditions resulting from sport or exercise

In 2001, around 545,200 Australians reported having a long-term condition caused by a sport or exercise related injury. This represented around 24% of those who had an injury related long-term condition. Like work related injuries, the most common sport or exercise related long-term condition were back pain and other problems. Joint injuries and arthropathies were also prevalent.

LONG-TERM CONDITIONS(a) FROM INJURY, Sport and exercise(b) - 2001

WORK

Recent injury while working for an income

Results from the 2001 NHS indicated that 486,100 persons aged 15 years and over reported one or more recent injuries while they were working for an income. This represented 31% of recently injured people aged 15 years and over and 5% of employed persons aged 15 years and over.

Young workers (aged 15-24 years) while working for income were injured at higher rates when compared to older workers and their rates of injury rose with longer hours. However, workers aged 15-24 years of age are employed in different occupations when compared to older workers (ABS 2001).

The occupation with the highest proportion of people recently injured while working for an income, was tradespersons and related workers (12%). People employed in the construction industry reported the highest proportion of injured workers (10%) (see table 26). Those working in the Accommodation, cafes and restaurants industry also had a high rate of injury (9.7%)

EMPLOYED PERSONS(a), Injured while working(b) - 2001

Proportion of employed

Employed

Working for an income

Proportion injured(c)

Proportion who had time off(d)

'000

'000

%

%

Industry

Retail Trade

1 155.1

78.3

6.8

*16.6

Manufacturing

1 072.0

67.5

6.3

23.3

Construction

649.9

64.7

10

*14.4

Accommodation, Cafes and Restaurants

435.6

42.5

9.7

*7.2

Agriculture, Forestry and Fishing

435.9

36.9

8.5

*38.0

All other industries

5 124.6

182.5

3.6

11.5

Occupation

Tradespersons and Related Workers

1 143.9

135.3

11.8

14.1

Intermediate Clerical, Sales and Service Workers

1 471.9

63.6

4.3

*12.5

Labourers and Related Workers

768.1

49.2

6.4

*12.4

Associate Professionals

1 043.0

46.5

4.5

*7.2

Managers and Administrators

771.5

41.5

5.4

*23.7

All other occupations

3 674.9

136.5

3.7

21.8

Total

8 873.2

472.4

5.3

16.1

* estimate has a relative standard error of between 25% and 50% and should be used with caution(a) Persons aged 18 years and over.(b) Working for an income.(c) Proportion injured while working for an income.(d) Proportion of those injured while working for an income who had time off as a result of the injury they received while working for an income.

Long-term conditions related to injury in the workplace

In 2001, around 819,000 Australians aged 15 years and over reported a long-term condition which was work related and caused by an injury received while at work. This represented 5% of all persons aged 15 years and over, and 37% of people aged 15 years and over who reported having a long-term condition caused by injury. The most common long-term condition related to work and caused by an injury received while at work were back problems, with disc disorders and joint injury also prevalent when compared to other conditions.

WORK-RELATED LONG-TERM CONDITIONS(a) FROM INJURY, While at work(b) - 2001

There is a steady increase with age in the proportion of people reporting work related long-term conditions received at work, until age 65 years and over, where the proportion decreases. The decrease in long-term conditions (i.e. conditions lasting six months or more) among those aged 65 years and over, may be the result of recovery from some conditions due to reduced participation in the workforce.